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. 2025 Mar 17:47:e-rbgo9.
doi: 10.61622/rbgo/2025rbgo9. eCollection 2025.

Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate

Giani Silvana Schwengber Cezimbra  1 , Edward Araujo Júnior  1 , Cristina Aparecida Falbo Guazzelli  1
Affiliations

Contraception in adolescents with mental disorders: adherence and satisfaction in the use of depot medroxyprogesterone acetate

Giani Silvana Schwengber Cezimbra et al. Rev Bras Ginecol Obstet. .

Abstract

Objective: To evaluate the continuation rate, satisfaction, and reasons for discontinuation of depot medroxyprogesterone acetate (DMPA) in adolescents treated in a mental health service.

Methods: Prospective cohort study conducted in a reference unit for the care of adolescents with mental disorders (MDs) and intellectual disabilities (IDs). All patients received a gynecological consultation and an educational group on contraceptive methods. Sociodemographic data on age, education and gynecological data (menarche, coitarche, regularity of menstrual cycles and presence of symptoms) were collected. Follow-up was quarterly for 12 months, during which symptoms, desire to continue, and satisfaction with the use of the quarterly injectable were assessed.

Results: Eight hundred and sixty-two sexually active adolescents were supported, 532 adolescents chose to use the quarterly injectable, and 69 of these agreed to participate in the study. The mean age of users was 15.5 years (SD=0.91). After 12 months of follow-up, 34 (49.3%) of the 69 adolescents continued to use the method and 36 (52.3%) were satisfied. Among the 33 (47.8%) who discontinued use, the most common reasons were irregular bleeding and weight gain.

Conclusions: Adolescents with intellectual disabilities and/or other mental disorders showed a significant rate of continuation and satisfaction with the use of the depot medroxyprogesterone acetate at 12 months, and the most common reasons for discontinuation were irregular uterine bleeding and weight gain.

Keywords: Contraception; Medroxyprogesterone acetate; Mental disorders; Pregnancy; Pregnancy in adolescence.

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Conflict of interest statement

Conflicts to interest: none to declare.

Figures

Figure 1
Figure 1. Flowchart of the included patients
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